HomeMy WebLinkAbout273449 PANDER COMPANY INC - INSURANCE CERTIFICATE,4COR�� CERTIFICATE OF LIABILITY INSURANCE
DATE(MM,DDYYYY)
9/3/2019
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: It the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy. certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
ArtJ Gallagher & Co. PONE Debbie Ara
hur FAX
Six Cesta Dr.. Ste. 5900 IAIC i 1 806-748-2015 AtC 1866-446-7371
AIL
Midland TX 79705 ADDRESS: dabbie_arandaCMajg.com
INSURED
Ponder Company, Inc
1545 W Tufts Ave. Suite B
Englewood CO 80110
PONOCOM-01
INSURER
A:
COVERAGES CERTIFICATE NUMBER:476247107 REVISION NUMBER:
22292
41840
22M
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
1�EXCLUSIONS
I —._—__ I POIICCV EFF � POLICCY EXP r
Tq TYPE OF INSURANCE - - -- --
L POLICY NUMBER MMlDDM'Y MMlDDl1'Y L1MTS
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE � OCCUR
ZHD-D028188-03 'I IU3112011 1131121211 EACH OCCURRENCE
LJAMAUli
li PR MISESET Ea�wrarrence
$1.000,000
5100,0DO
$10.000
MED EXP (Any one person)
$1,000,000
I
PERSONAL & ADV INJURY
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY X Jme `J LOC
S 2,000,000
GENERAL AGGREGATE
PRODUCTS -COMP/OPAGG
$2.00Q000
$
OTHER.
B
AUTOMOBILE LIABILITY AWD-D026195-03 I 8/31/2019
EV31/2020 COMBINEDINGLELIMIT
$1.000.000
y
X ANY AUTO
BODILY INJURY (Per person)
OWNED 77 SCHEDULED
ONLY �JI AUTOS
BODILY INJURY (Per accident)
f
HIREDAUTOS
NON -OWNED
4_
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
Par g�Cieam
t
E
A
X
UMBRELLA LIAB X OCCUR
UHD-D026191-03 8/312019 81312020 EACH OCCURRENCE
$5.000.000
f 5,000,000
LESS LIAR - CLAIMS -MADE
AGGREGATE
DIED X RETENTIONS
S
D WORKERSCOMPENSAT1oN TSF0002002365 8/31/2019 fi/31/2020 �X
D AND EMPLOYERS' LIABILITY YIN WC928538620214 8/31/2019 8131/2020 STAT TE ER
ANYPROPRIETOFbPARTNER:EXECUTIVE
OFFICERrMEMBEREXCLUDED? N r A EL EACH ACCIDENT
(Mandatory In NH) EL DISEASE EA EMPLOYEE
II yea, describe under
DESCRIPTION OF OPERATIONS bebw E.L. DISEASE - POLICY LIMIT
$1,000.000
$1.000,000
- -
$1,000,000
I
DESCRIPTION OF OPERATIONS f LOCATIONS r VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached If more spa" Is required)
ADDITIONAL INSURED,
Certificate Holder is an Additional Insured as respects to the General Liability & Automobile policy, pursuant to the policy s terms, definitions, conditions and
exclusions. Certificate Holder is included as Additional Insured on the General Liability & Automobile policy as per endorsement #421-0452. edition (12-14)
CG2037, edition (04-13) CG2010, edition (04-13) & 461-0478, edition (12.12),
WAIVER OF SUBROGATION'
Waiver of Subrogation applies to certificate holder, as respects to the General Liability & Automobile policy, pursuant to the policy's terms. definitions, conditions
See Attached..
City of Fort Collins
PO Box 580
Fort Collins. CO CO 80522
USA
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
ACORD 25 (2016/03)
01988-2015 ACORD CORPORATION. All riahts
The ACORD name and logo are registered marks of ACORD
Y of 3 10862